Creating The Bionic Woman
With the debut of NBC's "Bionic Woman," the notion of a bionic person is thought of as merely television fantasy. However, the bionic woman is getting closer to reality as reconstructive plastic surgeons perform quality-of-life-enhancing peripheral nerve surgeries once thought impossible. In fact, plastic surgeons are perfecting a nerve surgery that will allow humans to better interface with machines, giving amputees the ability to better move prosthetics, say presenters at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2007 conference in Baltimore.
"Peripheral nerves control the body's motor and sensory functions and injuries can be devastating, significantly impacting a patient's ability to perform normal activities," said W.P. Andrew Lee, MD, ASPS Member Surgeon and panel moderator. "We are restoring patients' movement through reconstructive plastic surgery that allows nerves and muscles to merge with, power, and move prosthetic devices. The bionic person is no longer just a Hollywood concept."
On the forefront, plastic surgeons are perfecting a new nerve transfer procedure where nerve fibers from a neighboring muscle are redirected to the damaged muscle to provide function. The nerve branches from the original muscle and the redirected nerve branches to the damaged muscle then compensate for the loss by growing extra branches. Within months, the damaged muscle regains function from the "borrowed" nerve fibers.
"Before, we had to wait for the nerve to slowly regenerate and hope the muscle was still healthy and had some functionality once the nerve reconnected to it," said Paul Cederna, MD, ASPS Member Surgeon and lecture presenter. "While plastic surgeons have been talking about this type of nerve transfer for some time, it wasn't until recently that we've successfully performed these operations."
Plastic surgeons are using the nerve transfer technique to help amputees gain better control and move their prostheses. Often, there is little muscle left following an upper arm amputation, making it difficult to maneuver the artificial limb. Surgeons are transferring the remaining nerves in the upper arm to chest and back muscles, allowing those muscles to help control and power prostheses.
Plastic surgeons are also making remarkable progress in peripheral nerve treatments that restore symmetry to patients with facial paralysis and in pain management -- particularly for diabetics and migraine headache sufferers.
Tissue walls in the feet of some diabetics can become stiff over time and tighten around nerves. Constricted nerves are also a cause of migraine headaches. Plastic surgeons are freeing the space around these nerves to relieve pressure and alleviate pain or numbness.
Patients with facial paralysis, due to trauma or tumors, often lose the ability to use facial muscles around the mouth which leads to asymmetry or a permanent frown. Having a permanent frown may negatively impact people's perceptions of an individual. Botox can be used to paralyze the normal functioning muscles while patients have physical therapy to strengthen the damaged muscles and restore symmetry to the face.
"The steps we are taking in peripheral nerve surgery are dramatically changing the way patients are treated and positively impacting their lives," said Ivica Ducic, MD, ASPS Member Surgeon and course instructor. "Considering what we've accomplished over the last several years, we are definitely entering into a new age of reconstructive plastic surgery."